A new study, published in the May 14 issue of the Journal of the American College of Cardiology, examines temporal trends in post-percutaneous coronary intervention (post-PCI) bleeding among patients with elective PCI, unstable angina (UA)/non–ST-segment elevation myocardial infarctionn (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).
The study uses these trends to determine the impact of bleeding avoidance strategies on post-PCI bleeding rates over time.
Based on data from the CathPCI Registry, researchers looked at temporal trends in post-PCI bleeding from 2005 to 2009 among patients with elective PCI, UA/NSTEMI and STEMI and quantified the linear time trend in bleeding. Researchers found a 20 percent reduction in post-PCI bleeding over time, largely due to temporal changes in antithrombotic strategies.
According to the study authors, this is the first paper to demonstrate a significant temporal reduction in major bleeding over time in the elective PCI and UA/NSTEMI population. Changes in vascular access strategies had a smaller impact on the change in bleeding risk, likely due to the extremely low prevalence of the radial approach and a small increase in the use of vascular closure device utilization during the study, they said. Temporal bleeding in STEMI did not change significantly.
It remains to be seen whether further changes in vascular strategies, particularly increased adoption of transradial PCI, newer antithrombotics, or both, will further reduce bleeding rates, particularly in the STEMI population. However, the authors note that future studies should continue to evaluate bleeding risk as the landscape of antithrombotic therapies and bleeding avoidance strategies continues to evolve. To access all key points of this study, read the CardioSource Journal Scan.
May has been a particularly busy month for the NCDR, which also published papers on the following topics: